Cycling and the Curious Problem of the Prostate

Few things completely change everything in a person’s life in one moment. This happened to me during a recent doctors visit. I went in for my yearly physical and also for some minor urinary problems. I suspected a medication was causing me urinary retention. The doctor finishes his exam and says that I have a high likelihood of cancer and need a prostate biopsy to be sure. Just like that. The doctor said it in the nicest way he could, but it was a moment that would change my life forever.

Right away I start thinking about all of the normal things, my family, my daughter may have to grow up without me, the chance I could be gone soon, how would people think of me, am I ok with myself, life insurance, etc. Very stressful times to be sure.

The next thing I did was tell all of my (male) friends that they should have a physical exam done and to not take anything for granted. If one is to beat cancer, it is through early detection. We cyclists like to think that we are the model of good health, and often only make it to the doctor when we think it necessary.

Then I thought more about the prostate, and realized that we cyclists are not very kind to our prostates. In fact, I wrote an article about inflammation of the prostate in Road Bike Action a while back. We apply pressure to our prostates for hours while riding, and rarely have problems. Prostate problems are partly due to our saddles and partly our genetic makeup. Cyclists and their saddles, an eternal problem even since cowboys saddled horses. A cyclist’ saddle needs to fit like a good pair of shoes that allow you to walk without pain for hours.

Prostate cancer is the second most lethal cancer in men after lung cancer. For men over 40, there is about a 1 in 40 chance of having prostate cancer, after 50 it goes to 1 in 20. It is often curable if one gets it, but it must be caught in time. This is why annual exams and a lab test called the prostate specific antigen (PSA) can be important.

Basically I had a fifty percent chance of my prostrate being positive for cancer based on age, physical exam and PSA. I had to go through with a prostate biopsy in the office under local anesthesia (not for the faint of heart). It would be a week before I would know the results. I started preparing myself for the decisions to come if it was cancer. I was ready for anything. Nothing like a cancer scare to help put things in perspective about who and what is important in your life. The answer may surprise you.

The biopsy results showed that I had acute bacterial prostatitis, it wasn’t cancer. It’s hard to know what to do with yourself at this point. You are happy for yourself, but more so for your family. Now I had to deal with the prostatitis. Prostatitis is an infection and inflammation of the prostate gland and occurs in part due to the pressure placed on the perineum by the seat while riding. It is often an extremely painful condition that requires antibiotics, anti-inflammatory medications and rest. It may rarely require surgery in severe cases. Fortunately, this problem is rare, but when it strikes, it can take you off of the bike for months at a time. In fact, one of our magazine editors contracted prostatitis just before he was scheduled to ride the Etape du Jour at the Tour de France. Not only was he unable to ride the event, but he was off the bike for almost 4 months.

Medical risk factors include a history of frequent urinary tract infections, prolonged pressure on the prostate gland, urethral trauma, previous prostatitis, and a condition called Benign Prostate Hypertrophy (enlarged prostate). Cycling risk factors include improper seat position insufficient padding by the chamois. Prostatitis occurs more frequently in older cyclists, but is has been reported in males in their early 20’s. See a Urologist promptly if you experience any of the symptoms mentioned above. Early treatment and prevention are the keys to avoiding this catastrophe.

Live long enough and we are all guaranteed to get cancer. The value of getting yearly exams cannot be underscored, early detection is what is going to save you if that’s possible. I have an acute awareness upon me after the fact that I now know I do not have cancer; it is a weird and wonderful awareness that you feel and you’re not sure what to do with it. The question is how I will decide to change in my life being given a second chance (for now). In my case, I wouldn’t change anything, I remained calm, willing to do whatever it takes. But I did reflect on how I treat others and myself, I can say that I believe I am good in this category.

This article is for information purposes only and seek qualified medical professionals for answers / help about the prostate. I am happy to answer any questions, just leave them on the site.